Provider Demographics
NPI:1518158104
Name:SABOURIN, SONDRA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:
Last Name:SABOURIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 WEST HENRIETTA
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863
Mailing Address - Country:US
Mailing Address - Phone:719-291-4388
Mailing Address - Fax:
Practice Address - Street 1:364 GRANITE RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:CO
Practice Address - Zip Code:80816-8219
Practice Address - Country:US
Practice Address - Phone:719-687-6145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional